S-1 Versus S-1 Plus Cisplatin as an Adjuvant Chemotherapy to Treat Gastric Cancer

NCT01426646 | Unknown Phase 2 DMC

• 1 other identifier: ACSPGC-01
• Study Type: interventional
• Target: 218
• Locations: 1 country
• Sites: 2

Brief Summary

Although there has been some progress in chemotherapy for metastatic gastric cancer, no standard regimen of adjuvant chemotherapy is available, and many clinical trials have produced contradictory results. The majority of randomized clinical trials studying adjuvant chemotherapy in gastric cancer have been underpowered, involved low-volume centers, or used ineffective chemotherapy regimens. As a result, well-designed multicenter trials are still needed. The ACTS-GC trial, which demonstrated the efficacy of S-1 for stage II-III gastric cancer patients who underwent curative resection with extended lymph-node dissection (D2), may be valid in countries where D2 surgery is considered the standard of care. S-1 improved the 3-year overall survival from 70.1% for surgery alone to 80.1%. However, 3-year overall survival in stage IIIA and stage IIIB patients receiving S-1 were 77.4% and 63.4%, respectively, which are less satisfactory compared to the rate for stage II (90.7%). Based on the unsatisfactory outcome among later stage patients in the ACTS-GC adjuvant trial, further investigation is needed for more effective postoperative treatment of patients with stage IIIB and IV (M0) cancer. Therefore, the researchers investigated the efficacy and safety of S-1 versus S-1 plus cisplatin as adjuvant chemotherapy in patient with curatively resected gastric adenocarcinoma.

Conditions

Gastric Cancer

Keywords

gastric cancer; S-1; cisplatin; adjuvant chemotherapy

Outcome Measures

Primary Outcomes (1)

• Relapse-free survival

  RFS was defined as the time from the date of surgery to relapse or death from any cause.

  3 years from enrollment.

Secondary Outcomes (1)

• Overall survival

  3 years from enrollment.

Study Arms (2)

S-1 treatment

EXPERIMENTAL

S-1 was administered at 40mg/m2 orally twice daily (days 1-28) every 42 days. Patients received a maximum of eight cycles.

Drug: S-1

S-1 plus cisplatin treatment

EXPERIMENTAL

S-1 plus cisplatin every 3 weeks, A total of eight cycles * S-1: 40mg/m2 orally twice daily (days 1-14) * Cisplatin: 60mg/m2 IV on day 1

Drug: S-1 plus cisplatin

Interventions

S-1 DRUG

S-1 was administered at 40mg/m2 orally twice daily (days 1-28) every 42 days. Patients received a maximum of eight cycles.

Also known as: TS-1

S-1 treatment

S-1 plus cisplatin DRUG

S-1 plus cisplatin every 3 weeks, a total of eight cycles * S-1: 40mg/m2 orally twice daily (days 1-14) * Cisplatin: 60mg/m2 IV on day 1

Also known as: TS-1, cisplatin

S-1 plus cisplatin treatment

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• years
• Histologically proven adenocarcinoma of the stomach
• Curative D2 lymphadenectomy resection for gastric cancer, who can be randomized to either study arm within 6 weeks after surgery
• Stage II, III and IV (M0)(AJCC 7th edition)
• Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
• No prior chemotherapy or radiotherapy
• Adequate bone marrow, renal, and liver function

You may not qualify if:

• Pregnant or lactating women.
• Women of childbearing potential with either a positive or no pregnancy test at baseline. Postmenopausal women must have been amenorrheic for at least 12 months to be considered of non-child bearing potential.
• Sexually active males and females (of childbearing potential) unwilling to practice contraception during the study.
• Any evidence of metastatic disease (including presence of tumor cells in the ascites).
• Previous cytotoxic chemotherapy, radiotherapy or immunotherapy except corticosteroids, for the currently treated gastric cancer.
• Major surgery within 4 weeks prior to study treatment start, or lack of complete recovery from the effects of major surgery.
• History of another malignancy within the last five years except cured basal cell carcinoma of skin and cured carcinoma in-situ of uterine cervix.
• Clinically significant (i.e. active) cardiac disease e.g. symptomatic coronary artery disease, New York Heart Association (NYHA) grade II or greater congestive heart failure or serious cardiac arrhythmia requiring medication or myocardial infarction within the last 12 months.
• Lack of physical integrity of the upper gastrointestinal tract or those who have malabsorption syndrome likely to influence absorption of capecitabine, or inability to take oral medication.
• Organ allografts requiring immunosuppressive therapy.
• Serious uncontrolled intercurrent infections or other serious uncontrolled concomitant disease.
• Prior unanticipated severe reaction to fluoropyrimidine therapy (with or without documented dihydropyrimidine dehydrogenase (DPD) deficiency) or patients with known DPD deficiency.
• Hypersensitivity to platinum compounds or any of the components of the study medications.
• Received any investigational drug or agent/procedure, i.e. participation in another trial, within 4 weeks before randomization.
• Blood transfusions or growth factors to aid hematologic recovery within 2 weeks prior to study treatment start.

Sponsors & Collaborators

• Kyungpook National University Hospital: lead

Study Sites (2)

Donga university hospital

Busan, 602-715, South Korea

RECRUITING

Ulsan University Hospital

Ulsan, 682-714, South Korea

RECRUITING

MeSH Terms

Conditions

Stomach Neoplasms

Interventions

S 1 (combination); titanium silicide; S-1 plus cisplatin; Cisplatin

Condition Hierarchy (Ancestors)

Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Stomach Diseases

Intervention Hierarchy (Ancestors)

Chlorine Compounds; Inorganic Chemicals; Nitrogen Compounds; Platinum Compounds

Study Officials

• Wansik Yu, Professor

  Kyungpook National University Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Byung Woog Kang, Professor

CONTACT

+82-10-9216-2633; bwkang@knu.ac.kr

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor(full time instructor)

Study Record Dates

• First Submitted: January 18, 2011
• First Posted: August 31, 2011
• Study Start: September 1, 2011
• Primary Completion: September 1, 2014
• Study Completion: September 1, 2016
• Last Updated: January 5, 2012

Record last verified: 2012-01

Locations

KR (2)